U.S. patent application number 16/249720 was filed with the patent office on 2019-07-18 for osteotome extractor.
The applicant listed for this patent is Tornier, Inc.. Invention is credited to Robert Courtney, JR., Jeffrey M. Ondrla.
Application Number | 20190216518 16/249720 |
Document ID | / |
Family ID | 46507934 |
Filed Date | 2019-07-18 |
United States Patent
Application |
20190216518 |
Kind Code |
A1 |
Courtney, JR.; Robert ; et
al. |
July 18, 2019 |
OSTEOTOME EXTRACTOR
Abstract
A surgical tool, enabling extraction of a prosthesis from a bony
implantation site of that prosthesis, defines a proximo-distal axis
and includes a distal end head adapted both to cut at least
partially the bonding interface between the prosthesis and the bony
material of the implantation site and to fix itself to the
prosthesis by rotation centered on the proximo-distal axis,
according to embodiments of the present invention.
Inventors: |
Courtney, JR.; Robert;
(Pierceton, IN) ; Ondrla; Jeffrey M.; (Warsaw,
IN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Tornier, Inc. |
Bloomington |
MN |
US |
|
|
Family ID: |
46507934 |
Appl. No.: |
16/249720 |
Filed: |
January 16, 2019 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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15046295 |
Feb 17, 2016 |
10213243 |
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16249720 |
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13553610 |
Jul 19, 2012 |
9289218 |
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15046295 |
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61509506 |
Jul 19, 2011 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/8872 20130101;
A61F 2/4603 20130101; A61F 2002/30426 20130101; A61F 2002/4619
20130101; A61F 2/4607 20130101; A61F 2/4612 20130101; A61B 17/16
20130101; A61B 17/1637 20130101 |
International
Class: |
A61B 17/88 20060101
A61B017/88; A61F 2/46 20060101 A61F002/46; A61B 17/16 20060101
A61B017/16 |
Foreign Application Data
Date |
Code |
Application Number |
Aug 10, 2011 |
FR |
1157282 |
Claims
1-22. (canceled)
23. A system comprising: an implant comprising a plurality of
apertures; and a tool comprising a plurality of elongate elements
extending distally from a main body of the tool along a direction
that is substantially parallel to a longitudinal axis of the tool,
each of the plurality of elongate elements comprising: a first edge
extending in a longitudinal direction; a second edge opposite the
first edge and extending in the longitudinal direction; and a
distal edge extending between the first edge and the second edge;
wherein each of the plurality of elongate elements is configured to
extend through a corresponding one of said plurality of apertures
of the implant; and wherein the plurality of elongate elements are
configured to at least partially separate an interface between the
implant and bony material at an implantation site of the
implant.
24. The system of claim 23, wherein the first edge is a cutting
edge.
25. The system of claim 23, wherein the first edge and the second
edge of each of the plurality of elongate elements is entirely
radially inward of an outer face of the respective elongate
element.
26. The system of claim 23, wherein there are no cutting edges
disposed radially inwardly of the plurality of elongate elements
disposed at the periphery of the distal face.
27. The system of claim 23, wherein each of the plurality of
elongate elements extends along a portion of a tubular periphery
centered on the longitudinal axis.
28. The system of claim 23, wherein the plurality of elongate
elements are spaced apart by substantially the same circumferential
separation.
29. The system of claim 23, wherein the plurality of elongate
elements comprises at least three elongate elements.
30. The system of claim 23, wherein, in use, the distal end of each
of the elongate elements is disposed at a distal-most edge of the
tool.
31. The system of claim 23, wherein the tool further comprises a
shaft extending along the longitudinal axis, wherein the distal end
of the shaft is affixed to the main body, and wherein a driving
handle is affixed to a proximal end of the shaft.
32. The system of claim 23, wherein each of the plurality of
elongate elements is configured to couple with the corresponding
one of said apertures upon rotation of the tool about the
longitudinal axis.
33. The system of claim 23, wherein the implant comprises a flange,
the flange comprising a proximal surface and a distal surface,
wherein the distal surface is configured to bear on the
implantation site, wherein the flange comprises the plurality of
apertures.
34. The system of claim 23, wherein the tool is configured to
extract the implant.
35. A system comprising: an implant comprising a flange having a
proximal surface and a distal surface, the flange comprising a
plurality of slots extending between the proximal surface and the
distal surface, the plurality of slots being circumferentially
spaced apart from each other; and a tool comprising a plurality of
elongate elements extending distally from a main body of the tool
along a direction that is substantially parallel to a longitudinal
axis of the tool; wherein each of the plurality of elongate
elements is configured to extend through a corresponding one of the
plurality of the slots of the implant; and wherein the plurality of
elongate elements are configured to at least partially separate an
interface between the implant and bony material at an implantation
site of the implant.
36. The system of claim 35, wherein the implant comprises an anchor
body extending from the flange along a longitudinal axis of the
implant, the anchor body comprising a cylindrical body and a
plurality of arms extending from the cylindrical body.
37. The system of claim 36, wherein each of the plurality of slots
has a first edge aligned with a radially outer periphery of the
cylindrical body and a second edge spaced radially outward from the
first edge, the first edge and the second edge separated by a
gap.
38. The system of claim 36, wherein each of the plurality of slots
is configured to guide a corresponding one of the plurality of
elongate elements between two of the plurality of arms of the
implant.
39. The system of claim 35, wherein each of the plurality of slots
is shaped to guide introduction of a corresponding one of the
plurality of elongate elements.
40. The system of claim 35, wherein each of the plurality of slots
is configured to guide longitudinal translation of a corresponding
one of the plurality of elongate elements.
41. The system of claim 35, wherein a width, measured radially with
respect to a longitudinal axis of the implant, of each of the
plurality of slots corresponds to a radial thickness of a
corresponding one of the plurality of elongate elements.
42. The system of claim 35, wherein a length, measured in a
direction transverse to a longitudinal axis of the implant, of each
of the plurality of slots is substantially equal to a peripheral
extent of a corresponding one of the plurality of elongate
elements.
43. The system of claim 35, wherein the implant comprises a
cylindrical anchor body extending from the flange and each of the
elongate elements has a curvature corresponding to the curvature of
the cylindrical anchor body.
44. The system of claim 35, wherein the tool is configured to
extract the implant.
45. A system comprising: an implant comprising a plurality of
apertures; and a tool comprising: a main body; and means for
separating an interface between the implant and bony material at an
implantation site of the implant, the separating means interfacing
with the plurality of apertures in the implant.
46. The system of claim 45, wherein the implant comprises a flange
having a proximal surface and a distal surface, the flange
comprising the plurality of apertures.
47. The system of claim 45, wherein the plurality of apertures are
circumferentially spaced apart from each other.
48. The system of claim 45, wherein the implant comprises an anchor
body extending from the flange along a longitudinal axis of the
implant, the anchor body comprising a cylindrical body and a
plurality of arms extending from the cylindrical body.
49. The system of claim 45, wherein the plurality of apertures are
configured to guide longitudinal translation of the tool.
50. The system of claim 45, wherein the separating means comprises
a notch defined along a direction extending distally of the main
body.
51. The system of claim 45, wherein the notch is defined along a
circumferential edge of the separating means.
52. The system of claim 45, wherein the tool is configured to
extract the implant.
53. A method for separating an implant from a bone, the method
comprising: interfacing a tool with an implant having a flange, the
flange having a proximal surface and a distal surface, the distal
surface bearing on or facing the bone, the flange having at least
one aperture formed through the flange; inserting at least one
elongate element through the at least one aperture from the
proximal surface to the distal surface and into the bone; at least
partially separating a bonding interface between the implant and
the bone using the at least one elongate element.
54. The method of claim 53, wherein the at least one elongate
element extends distally from a main body of the tool along a
direction that is substantially parallel to a longitudinal axis of
the tool.
55. The method of claim 53, wherein the at least one aperture is
three apertures formed through the flange, wherein the at least one
elongate element is three elongate elements extending distally from
the main body, the method further comprising inserting
simultaneously each of the at least three elongate elements through
one of the at least three apertures and into the bone.
56. The method of claim 53, further comprising extracting the
implant from the bone using the tool.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application is a continuation of U.S. patent
application Ser. No. 15/046,295, filed on Feb. 17, 2016, which is a
divisional of U.S. patent application Ser. No. 13/553,610, now U.S.
Pat. No. 9,289,218, filed on Jul. 19, 2012, which claims the
benefit of U.S. Provisional Patent Application Ser. No. 61/509,506,
filed on Jul. 19, 2011, and claims foreign priority to French
Patent Application No. 20110057282, filed Aug. 10, 2011, both of
which are incorporated by reference herein in their entireties for
all purposes.
TECHNICAL FIELD
[0002] Embodiments of the present invention relate to a surgical
tool for extraction of a prosthesis from a bony implantation site
of that prosthesis as well as a surgical kit including such a
surgical tool and such a prosthesis.
BACKGROUND
[0003] When a prosthesis has been implanted in a bone for a certain
time, typically several years, it may prove necessary to remove the
prosthesis for various reasons: for example, wear of the
prosthesis, degeneration of the bony material of the prosthesis
implantation site, trauma, and the like. The prosthesis removed is
generally replaced by a revision prosthesis, the success and the
implantation performance of which depend on the residual stock of
bony material after removing the initial prosthesis. Consequently,
surgeons aim to limit as much as possible any cutting of bony
material necessary to free and extract the initial prosthesis.
[0004] With the arrival of prostheses with a porous surface or,
more generally, adapted to have their surface colonized by the bone
of the implantation site, extraction operations may prove
particularly delicate. To this end, the surgeon generally employs
osteotomes, the application of which may advantageously be guided
to improve the precision of their action. Then, once the bonding
interface between the prosthesis and the bony material has been cut
in this way by these osteotomes, the surgeon uses another surgical
tool to grasp and pull on the prosthesis in order to extract
it.
SUMMARY
[0005] Embodiments of the present invention include an improved
extraction surgical tool that facilitates and enhances the gestures
of the surgeon. Embodiments of the present invention include a
surgical tool for extraction of a prosthesis from a bony
implantation site of that prosthesis, the surgical tool defining a
proximo-distal axis and including a distal end head adapted both to
cut at least partially the bonding interface between the prosthesis
and the bony material of the implantation site and to fix itself to
the prosthesis by a bayonet connection centered on the
proximo-distal axis.
[0006] Embodiments of the present invention may also include a
surgical kit, including a surgical tool as described above and a
bone implantation prosthesis that includes a body to be anchored in
the bony material of the implantation site, the anchor carrying
externally at least part of the bonding interface between the
prosthesis and the bony material of the implantation site and
including a flange bearing on the implantation site, this flange
being adapted to be fixed to the distal end head of the surgical
tool by the bayonet connection.
[0007] While multiple embodiments are disclosed, still other
embodiments of the present invention will become apparent to those
skilled in the art from the following detailed description, which
shows and describes illustrative embodiments of the invention.
Accordingly, the drawings and detailed description are to be
regarded as illustrative in nature and not restrictive.
BRIEF DESCRIPTION OF THE DRAWINGS
[0008] FIG. 1 is a perspective view of a surgical tool, according
to embodiments of the present invention.
[0009] FIG. 2 is a perspective view as seen from a different angle
and to a larger scale than FIG. 1 of a portion of the surgical tool
from FIG. 1, according to embodiments of the present invention.
[0010] FIG. 3 is a view in elevation in the direction of the arrow
III in FIG. 2, according to embodiments of the present
invention.
[0011] FIGS. 4 to 6 are views similar to FIGS. 1 to 3,
respectively, showing the surgical tool from FIG. 1 associated with
a prosthesis to be extracted with the aid of that surgical
tool.
[0012] While the invention is amenable to various modifications and
alternative forms, specific embodiments have been shown by way of
example in the drawings and are described in detail below. The
intention, however, is not to limit the invention to the particular
embodiments described. On the contrary, the invention is intended
to cover all modifications, equivalents, and alternatives falling
within the scope of the invention as defined by the appended
claims.
DETAILED DESCRIPTION
[0013] In FIGS. 1 to 3 there is represented a surgical tool 1 for
extracting a prosthesis from a bony implantation site of that
prosthesis. As seen clearly in FIG. 1, this surgical tool 1 has an
elongate overall shape, centered on a longitudinal axis X-X which,
in use, extends in a direction which, at the proximal end, faces
toward the surgeon and, at the distal end faces toward the bony
implantation site of the prosthesis to be extracted.
[0014] The surgical tool 1 includes a shaft 2 that is centered on
and extends lengthwise along the axis X-X and which includes a
cylindrical rod of circular section. At its proximal end 2A, the
shaft 2 is provided with a fixed handle 4 arranged transversely to
the axis X-X, in order to facilitate driving, for example manual
driving, of the surgical tool 1 by a user. This handle 4 may be
formed in the shape of a "T". In its main part 2B, the shaft 2 is
fixedly provided with a shoulder 6 projecting radially from the
rest of the shaft 2. The shoulder 6 may be comprised of a disc
centered on the axis X-X. Alternatively, shoulder 6 may be a
cylindrical handle, a roughened surface, one or more indentations,
one or more protrusions, or any other shape which permits shoulder
6 to receive a traction force and transmit the traction force to
the shaft, according to embodiments of the present invention.
[0015] At its end 2C, the shaft 2 includes a fixed head 8 that
cooperates mechanically with a prosthesis to be extracted. As
illustrated in FIGS. 1 to 3, this head 8 includes a main body 10
that is centered on the axis X-X and is generally disc-shaped.
According to one embodiment, the head 8 includes three elements 12,
which may be separate and identical. In other embodiments, the head
8 may include one, two, three, four, five, six or more elements 12.
In still other embodiments, the elements 12 may not be identical
and one or more element 12 may have different lengths, widths,
thicknesses, curvatures, or other features as compared to one or
more other elements 12. Each element 12 may have a shape that is
elongate in the direction of the axis X-X and projects in the
longitudinal axial direction from the distal face 10A of the main
body 10 of the head 8. According to some embodiments of the present
invention, each element 12 projects from a portion of the external
periphery of the distal face 10A of the body 10. Each element 12 as
a whole corresponds to a portion of a tubular wall centered on the
axis X-X and projecting axially from the exterior periphery of the
face 10A of the body 10, according to embodiments of the present
invention. Elements 12 may be referred to as cutting elements,
according to embodiments of the present invention.
[0016] According to one embodiment, the three elements 12 are
distributed, for example, in a substantially regular manner (e.g.
separated by substantially the same radial angles) around the axis
X-X. In particular, these three elements 12 may correspond to
respective portions of the same tubular wall. According to other
embodiments, the two or more elements 2 are distributed in an
irregular manner on the distal head 8, and are either not separated
by similar radial angles, and/or are not situated about a perimeter
of the distal head 8. For example, the elements 12 may be
positioned on distal head 8 at different or staggered radial
distances from the axis X-X, and may be positioned at different or
staggered radial separations with respect to the axis X-X.
[0017] As shown in FIGS. 1 to 3, each element 12 has, axially
opposite its proximal end connecting the rest of the element to the
main body 10 of the head 8, a distal free edge 12A along which a
cutting edge is formed in a direction peripheral to the axis X-X.
Each element 12 may be delimited in a direction peripheral to the
axis X-X by two opposite longitudinal free edges 12B and 12C. The
longitudinal edge 12B, which is that oriented in the clockwise
direction about the axis X-X when the head 8 is viewed from the
proximal end 2A of the shaft 2, has, in its longitudinal direction,
a distal end part 126.1 along which a cutting edge is formed and a
proximal end part 126.2 in which a recessed notch 14 is delimited.
Edge 12B may also be referred to as leading edge 12B, and edge 12C
may be referred to as trailing edge 12C, according to embodiments
of the present invention.
[0018] An example of use of the surgical tool 1 will now be
described with reference to FIGS. 4 to 6.
[0019] In these FIGS. 4 to 6, the head 8 of the surgical tool 1
cooperates with a prosthesis 20 to be extracted including an anchor
body 22 anchored in the bony material of an implantation site of
the prosthesis. This anchor body 22 is provided with a flange 24
which bears on the aforementioned implantation site. In some
embodiments of the present invention, when the prosthesis 20 is in
an implantation configuration, its body 22 is engaged depthwise in
the bony material of the implantation site and its flange 24
remains outside or partially outside the bony material of the
implantation site, bearing on the perimeter surface of the hole at
the implantation site in which the body 22 is housed. Consequently,
if a surgeon wishes to extract the prosthesis 20 from the
aforementioned implantation site, the proximal face 24A of the
flange 24 is directly accessible, whereas the distal face 24B of
the flange 24 bears on the bony material of the implantation site.
Given the context of the surgical intervention, the interface
between the prosthesis 20, and more precisely the body 22 of that
prosthesis, and the bony material of the implantation site proves
resistant to extraction of the prosthesis 20 in the sense that,
over time, a mechanical-biological bond has progressively formed at
this interface between the prosthesis and the bony material. The
strength of this bonding interface often proves particularly high
in the situation in which the body 22 has a porous structure or,
more generally, an exterior surface suitable for osteo-integration,
as is generally the case when the prosthesis 20 is a prosthesis
implanted without cement.
[0020] As used herein, the term "flange" is used in its broadest
sense to refer to any structure or shape which has a proximal
surface and a distal surface and is capable of contacting bone or
being positioned on or near bone. For example, a flange may have a
circular, square, rectangular, triangular, or other (regular or
irregular) polygonal shaped cross-section along a dimension that is
substantially perpendicular to the axis X-X, according to
embodiments of the present invention. The perimeter of the flange
may be smooth and/or continuously contoured, or may include
straight segments, and/or may include a combination of both
contoured and straight segments.
[0021] To extract the prosthesis 20, the surgeon grasps the shaft 2
of the surgical tool 1, notably by hand, and moves the head 8
toward the prosthesis 20, substantially aligning the axis X-X with
a central geometrical axis of the prosthesis 20, in particular the
central geometrical axis around which the flange 24 extends
peripherally. The distal edge 12A of each element 12 of the head 8
can then be used to cut at least in part the bonding interface
between the prosthesis 20 and the bony material of the implantation
site. To this end, the flange 24 is provided with three
through-slots 26 each of which connects the proximal face 24A and
the distal face 24B of the flange 24 to each other. Each slot 26
has a cross section allowing, or even in some cases guiding,
introduction into this slot of one of the elements 12, in a
movement in translation oriented along the axis X-X and directed in
the distal direction. In other words, each slot 26 may have a
cross-sectional shape corresponding to a flat ring portion the
width of which considered radially with respect to the axis X-X
substantially corresponds to the radial thickness of each element
12 and the length of which, in a direction peripheral to the axis
X-X, is substantially equal to the peripheral extent of the element
12, as illustrated in FIGS. 4 and 5, according to embodiments of
the present invention.
[0022] The distal edge 12A of the elements 12 is introduced first
into one of the slots 26 and projects therefrom, at the distal end,
cutting the portion of the (bony) bonding interface between the
prosthesis 20 and the bony material that it encounters on its
trajectory in translation. The surgeon continues to drive the
surgical tool 1 in translation distally along the axis X-X until
the distal face 10A of the body 10 comes to bear against or in the
immediate vicinity of the proximal face of the prosthesis 20, for
example with the interior periphery of the proximal face 24A of the
flange 24.
[0023] The surgeon then rotates the shaft 2 on itself about the
axis X-X, in some cases using the handle 4 to increase the driving
torque. In some cases, use of the handle 4 increases the driving
torque tenfold. The head 8 is then driven in a similar rotary
movement, causing the longitudinal edge 12B of each of its elements
12 to follow a circular trajectory, centered on the axis X-X, and,
in the embodiment shown, in the clockwise direction. The distal end
part 12B.1 of each of the edges 12B then cuts the part of the
bonding interface between the body 22 of the prosthesis 20 and the
bony material of the implantation site, situated on the circular
trajectory of the edge 12B. At the same time, each notch 14 of the
longitudinal edges 12 mechanically engages the flange 24 in the
direction in which, given the rotary movement of the head 8 on
itself about the axis X-X relative to the prosthesis 20, one of the
peripheral ends of each slot 26 is introduced into the notch 14.
This cases the slots 26 to become engaged, in a direction
peripheral to the axis X-X, axially between the opposite axial
edges of the notch 14. This rotation drive movement is continued by
the surgeon so as to engage the flange 24 as far as to the bottom
of the notches 14. The surgical tool 1 and the prosthesis 20 are
then in the configuration of use represented in FIGS. 4 to 6.
[0024] Although notch 14 is shown as having an "L" shape, notch 14
may alternatively have other shapes, according to embodiments of
the present invention. For example, the shape of notch 14 may be
fully or partially curved, for example in a "U" shape, or may be
segmented, for example in a "V" shape, according to embodiments of
the present invention. Notch 14 may include any shape which is
capable of accepting at least a portion of the inside edge of an
aperture 26 upon rotation of the head 8, according to embodiments
of the present invention. In one embodiment, the proximal end of
notch 14 is delimited by a distal surface of the head 8 as shown in
FIG. 3. In another embodiment, the proximal edge of notch 14 is
located distally of the distal surface of the head 8. The shape of
the proximal edge of the notch 14 may also take numerous forms, for
example straight, curved, or a combination of straight and curved,
according to embodiments of the present invention.
[0025] Although clockwise rotation is described, one of ordinary
skill will appreciate, based on the present disclosure, that the
tool 1 may alternatively be configured for counterclockwise
rotation, according to embodiments of the present invention.
[0026] Upon engagement of the tool 1 with the prosthesis 20, the
mechanical connection that the surgeon establishes between the head
8 of the surgical tool 1 and the flange 24 of the prosthesis 20 is
a bayonet connection centered on the axis X-X, according to
embodiments of the present invention.
[0027] The surgeon may exert a traction force along the axis X-X,
directed in the proximal direction. The surgeon makes use of the
shoulder 6, for example by mechanically engaging this shoulder 6
with an ad hoc tool (not shown), enabling the surgeon to increase
(e.g. tenfold) the applied force to apply to the shaft 2 axial
traction loads directed in the proximal direction. As the bonding
interface between the prosthesis 20 and the bony material of the
prosthesis implantation site has been cut in several areas, by the
successive action of the distal edges 12A and the distal end parts
12B.1 of the longitudinal edges 12B of the elements 12, remaining
uncut areas of this bonding interface are broken in a controlled
manner as to their location, and easily, without the surgeon having
to exert too great a traction force.
[0028] Thus the surgical tool 1 enables the prosthesis 20 to be
extracted easily and quickly, it being noted that, due at least in
part to its bayonet fixing, integrating partial cutting of the
bonding interface between the prosthesis and the bony material of
the implantation site, the surgeon does not need to use two
separate instruments to turn and turn about to cut the
aforementioned interface and then make the mechanical attachment to
the prosthesis to be pulled.
[0029] Various modifications and additions can be made to the
exemplary embodiments discussed without departing from the scope of
the present invention. For example, while the embodiments described
above refer to particular features, the scope of this invention
also includes embodiments having different combinations of features
and embodiments that do not include all of the described features.
Accordingly, the scope of the present invention is intended to
embrace all such alternatives, modifications, and variations as
fall within the scope of the claims, together with all equivalents
thereof.
* * * * *